Differences of Ampicillin and Cefazolin Effects in Reducing hs-CRP Level in Premature Rupture of Membranes

Background: Premature rupture of membranes (PROM) is a rupture of amniotic sac before delivery. PROM is associated with an increased incidence of preterm labor and infection. The use of prophylactic antibiotic may reduce the risks of infection. High-sensitivity C-reactive protein (hs-CRP) is an acute-phase reactant protein that is associated with PROM. How much effect of prophylactic antibiotic to hs-CRP level remains unclear.Objective: To compare the reduction in hs-CRP levels in premature rupture of membranes before and after given ampicillin or cefazolin.Methods: The design of this study was true experimental design (pre and post-test) conducted at Dr. Kariadi General Hospital Medical Center Semarang and Kartini General Hospital Jepara from September 2019 to January 2020. Study samples are pregnant women with premature rupture of membranes that came to the Emergency Department and Maternity Ward Dr. Kariadi General Hospital Medical Center Semarang and Kartini General Hospital Jepara. Samples were divided into two groups, a group treated with ampicillin and the other with cefazolin therapy. All samples were subjected to a hs-CRP examination. Statistical analysis was performed by Mann-Whitney and Wilcoxon.Results: There are no significant differences in the age variable (28.8 ± 6.54 vs 29.1 ± 5.93), gestational age (36.3 ± 2.55 vs 36.3 ± 2.90), and parity (2,2 ± 0.99 vs 2.47 ± 1.19) in the ampicillin and cefazolin groups (p> 0.05). In this study, 37.1% patients have a history of PROM while 62.9%. had no history of PROM. Reduction in hs-CRP levels after administration of ampicillin and cefazolin was significant (4.4 ± 2.65 mg/L vs 6.3 ± 4.43 mg/L, respectively, p = 0.03). The difference in the decrease in hs-CRP levels before and after given ampicillin and cefazolin was significant (p = 0.0001). Conclusion: There is a decrease in hs-CRP levels after the administration of ampicillin or cefazolin in PROM, whereas cefazolin induced higher reduction in hs-CRP levels. Ampicillin can still be used as a first-line prophylactic antibiotic in primary healthcare facilities

PERBEDAAN KADAR HEMOGLOBIN PASIEN MIELOMA MULTIPEL PADA BERBAGAI STADIUM (Studi Observasional di RSUP Dr. Kariadi)

Background: Hemoglobin is one of red blood cell components which transport the oxygen in the respiration system. Patients with multiple myeloma has lower hemoglobin level based on each different stage of this disease. The decreasing of hemoglobin level gives influence to the nutritional status of patients with multiple myeloma. The objective of this research is to prove the difference of hemoglobin level among multiple myeloma patients in various stage. Methods: This research is a retrospective study using sixty patients with multiple myeloma in Kariadi Hospital as research samples. The samples are patients of multiple myeloma in Kariadi Hospital during January 2005 until December 2009. The samples had hemoglobin examinated by the data from medical record. The data was analyzed by descriptical and analytical analysis using One Way Anova and Post Hoc test with SPSS for Windows 18. Result: The age of multiple myeloma patients is ranging from 53,6 years old ± 14,07, while the average level of hemoglobin is ranging from 8,8 mg/dl ± 3,10. Most of the multiple myeloma patients were male (73,3 %). Based on the stage, there were 13,3 % at the 1st stage, 45,0% at the 2nd stage and 41,7% at the 3rd stage. There was significant differences of hemoglobin level in various stage of multiple myeloma (p=0,000). The Post Hoc test shows significant differences of hemoglobin level between 1st stage and 2nd stage (p=0,001), differences between 1st stage and 3rd stage (p=0,000), and differences between 2nd stage and 3rd stage (p=0,046). Conclusion: There is a decreasing level of hemoglobin in patients with multiple myeloma. The higher stage of multiple myeloma, the lower its hemoglobin level. Keywords: hemoglobin level, multiple myeloma stag